Department of Radiology, the First Affiliated Hospital, College of Medicine Zhejiang University, 79 Qingchun road, Hangzhou, 310003, China.
Department of Laboratory Medicine, the First Affiliated Hospital, College of Medicine Zhejiang University, 79 Qingchun road, Hangzhou, 310003, China.
Cancer Imaging. 2018 Oct 17;18(1):37. doi: 10.1186/s40644-018-0170-8.
Imaging findings for pancreatic neuroendocrine carcinoma (PNEC) and pancreatic ductal adenocarcinoma (PDAC) often overlap. The aim of this study was to demonstrate the value of computed tomography (CT) imaging features and texture analysis to differentiate PNEC from PDAC.
Twenty-eight patients with pathologically-proved PDAC and 14 patients with PNEC were included in this study. CT imaging findings, including tumor boundary, size, enhancement degree, duct dilatation and parenchymal atrophy were used to compare PDAC and PNEC. CT texture features were extracted from CT images at the arterial and portal phases.
More PNEC than PDAC had well-defined margins (57.1% vs 25.0%, p = 0.04). Parenchymal atrophy was more common in PDAC than in PNEC (67.9% vs 28.1%, p = 0.02). CT attenuation values (HU) and contrast ratios of PNEC inthe arterial and portal phases were higher than those of PDAC (p < 0.05 or 0.01). Entropy was lower and uniformity was higher in PNEC compare to PDAC at the arterial phase (p < 0.05). Contrast ratio showed the highest area under curve (AUC) for differentiating PNEC from PDAC (AUC = 0.98-0.99). Entropy and uniformity also showed an acceptable AUC (0.71-0.72).
Our data indicate that CT imaging features, including tumor margin, enhanced degree and parenchymal atrophy, as well as texture parameters can aid in the differentiation of PNEC from PDAC.
胰腺神经内分泌癌（PNEC）和胰腺导管腺癌（PDAC）的影像学表现常常重叠。本研究旨在展示 CT 成像特征和纹理分析在区分 PNEC 和 PDAC 方面的价值。
本研究纳入了 28 例经病理证实的 PDAC 患者和 14 例 PNEC 患者。比较 PDAC 和 PNEC 患者的 CT 成像特征，包括肿瘤边界、大小、强化程度、胰管扩张和实质萎缩。从动脉期和门静脉期 CT 图像中提取 CT 纹理特征。
PNEC 比 PDAC 更常见边界清晰（57.1%比 25.0%，p=0.04）。PDAC 比 PNEC 更常见实质萎缩（67.9%比 28.1%，p=0.02）。PNEC 在动脉期和门静脉期的 CT 衰减值（HU）和对比率均高于 PDAC（p<0.05 或 0.01）。PNEC 在动脉期的熵值低于 PDAC，均匀性高于 PDAC（p<0.05）。对比率在区分 PNEC 和 PDAC 方面具有最高的曲线下面积（AUC）（AUC=0.98-0.99）。熵和均匀性也具有可接受的 AUC（0.71-0.72）。
我们的数据表明，CT 成像特征，包括肿瘤边界、强化程度和实质萎缩，以及纹理参数有助于区分 PNEC 和 PDAC。
